Cardiac therapy can play a major role in improving the well being of cardiovascular patients. The therapy prescribed can depend upon the clinical stage of the cardiovascular disorder and can include a combination of medication, dietary restriction or modification, and physical activity limits. Other therapies are possible. Therapy can continue indefinitely as an aid to preventing disease progression and improving clinical status, as well as to reduce future risk.
Generally, patients that undergo a managed therapy regimen following a diagnosis and treatment for a cardiovascular disorder, such as coronary artery bypass grafting or percutaneous coronary artery stenting, benefit from improved survival rate and decreased co-morbidity occurrence. Effective cardiac therapy can help improve quality and length of life and can be instrumental in preventing the progress of the underlying cardiovascular syndrome, provided the patient conscientiously adheres to the regimen.
The management of cardiovascular disorders generally includes three aspects, such as described in E. Braunwald, ed., “Heart Disease—A Textbook of Cardiovascular Medicine,” Ch. 17, pp. 492-514, W.B. Saunders Co. (5th ed. 1997), the disclosure of which is incorporated by reference. The first aspect, removing or ameliorating the underlying cause, addresses evaluating treatable causes through, for instance, surgical intervention to correct or repair cardiac abnormalities. The second aspect, removing precipitating causes, includes recognizing, treating, and preventing specific entities that cause or exacerbate the cardiac condition. Precipitating causes include arrhythmias, systemic infection, pulmonary embolism, physical, environmental and emotional excesses, cardiac infection and inflammation, unrelated co-morbidities, cardiac depressants or salt-retaining drugs, high-output states, and development of a second form of heart disease. The third aspect addresses controlling the cardiac disorder state.
Detection and diagnosis of significant changes in health status can remain undetected in non-closely followed cardiac patients. Even patients with serious underlying cardiac conditions may be relatively asymptomatic provided that they carefully adhere to the treatment regimen. Departures from a treatment regimen are common precipitating causes and can lead to patient decompensation. For instance, stented patients are at risk of developing atrial fibrillation, ventricular tachycardical, and similar disorders. Similarly, undiagnosed atrial fibrillation or Bradycardia can lead to rhythm-related co-morbidity conditions. Close patient following is needed to minimize risks of future complications.
Increasing the frequency of clinical follow-up is neither practicable nor necessary in all cases, particularly as over prescribed follow-up can adversely affect quality of life and increase healthcare costs. Moreover, physiometry collected during clinical visits only provide an intermittent “snapshot” of patient wellness removed in both time and place from real world situations that the patient encounters. Conventional patient therapy monitoring systems, however, fail to adequately address providing effective patient following that is closely tied to specific medical therapy regimens.
U.S. Pat. No. 6,168,563, to Brown, discloses a system and method that enables a healthcare provider to monitor and manage a health condition of a patient. A clearinghouse computer communicates with the patient through a data management unit, which interactively monitors the patient's health condition. In a further embodiment, a simple and inexpensive system uses a Nintendo Gameboy to query and allow a patient to enter information and blood glucose measurements. The data is stored in a cartridge that can be accessed directly or via a remote computer. Physiological monitoring devices, such as a blood glucose monitor or peak-flow meter, may also supply patient information. Healthcare professionals can access the patient information through the clearinghouse computer, which can process, analyze, print, and display the data. Although the clearinghouse computer can generate scripts of patient queries to address specific healthcare concerns identified by a physician, Brown fails to disclose corroborating monitoring results to a medical therapy regimen.
U.S. Pat. No. 6,418,346 issued Jul. 9, 2002, to Nelson et al., describes an apparatus and method for remote therapy and diagnosis that includes a personal data manager (PDM) used in a Web-based network. The PDM cooperates with a programmer to remotely monitor IMDs on a chronic basis. The PDM is implemented to store and forward information to personal computers and similar equipment, or to uplink data from a programmer to a Web-based export data center. The PDM provides an extension to the programmer and operates as a data messenger between the programmer, export data center, and IMDs. Nelson fails to disclose corroborating monitoring results to a medical therapy regimen.
U.S. Pat. No. 6,263,245 issued Jul. 17, 2001, to Snell, describes a system and method for portable implantable device interrogation that can conduct wireless interrogation of an IMD. A portable interrogation device can be directly interfaced with a data processing device, such as a programmer/analyzer. The portable interrogation device includes a control circuit for controlling transmission using telemetry, transmitter for sending signals, receiver for receiving data transmitted by an IMD in response to interrogation signals, memory for storing data received, and electronic communications interface for high-speed delivery of data to the data processing device. However, the device only facilitates relay of data without analysis or processing and fails to provide corroborating monitoring results to a medical therapy regimen.
Therefore, there is a need for providing a patient therapy compliance monitor coupled to actively and regularly monitoring a therapy regimen performed by a patient having a cardiovascular disorder.